Blood cell therapy最新文献

{"title":"Dosing Subcutaneous Immunoglobulin to Achieve Target Levels in Hematopoietic Cell Transplant Recipients.","authors":"Shigeo Fuji, Makiko Suga, Yuma Tada, Yasuhiro Shingai, Hidenori Kasahara, Sayako Yuda, Takafumi Yokota, Jun Ishikawa","doi":"10.31547/bct-2025-030","DOIUrl":"10.31547/bct-2025-030","url":null,"abstract":"<p><p>Secondary hypogammaglobulinemia (SHG) is a frequent complication after hematopoietic cell transplantation (HCT), especially allogeneic HCT, and predisposes to recurrent or severe infections. Immunoglobulin replacement therapy (IgRT) is commonly used, but the dose-response relationship between subcutaneous IgRT (ScIgRT) and serum IgG levels after HCT remains insufficiently defined. We assessed the association between ScIgRT dose and short-term changes in IgG. We performed a single-center retrospective cohort study of patients who initiated ScIgRT ≥ 60 days after autologous or allogeneic HCT (2017-2023). Eligibility required IgG measurement within 1 week before and 1 month (±1 week) after initiation; patients who received intravenous IgRT within 1 month or had active relapse/progression were excluded. Change in IgG was compared using the Mann-Whitney U test, and dose-response was evaluated with Pearson correlation (two-sided <i>p</i> < 0.05). Eighty-one patients met criteria (median age, 57 years [19-75]; 73 [90.1%] allogeneic). ScIgRT was initiated a median of 124 days after HCT. Median IgG increased from 669 to 780 mg/dL at 1 month (<i>p</i> < 0.01). Monthly ScIgRT dose correlated with the magnitude of IgG rise (r=0.51, <i>p</i> < 0.01). Doses ≥ 24 g/month produced greater median increases than < 24 g/month (163 vs. 59 mg/dL, <i>p</i> < 0.01). Higher ScIgRT dosing was associated with larger short-term increases in IgG among HCT recipients with SHG. These findings support dose optimization to achieve target IgG troughs and justify prospective studies to determine whether maintaining higher IgG levels reduces infections and improves post-transplant outcomes.</p>","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 2","pages":"60-64"},"PeriodicalIF":0.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral Nerve Infiltration by CAR T-cells in a Case of Mononeuritis Multiplex after Ciltacabtagene Autoleucel.","authors":"Hitomi Hosoya, Kun-Wei Song, Kyle Dyson, Gabrielle Dufort, Bita Sahaf, Aaron Rosenberg, Surbhi Sidana, David Miklos, Hannes Vogel, Sebastian Fernandez-Pol, Srikanth Muppidi, Brian Scott, Lekha Mikkilineni","doi":"10.31547/bct-2025-027","DOIUrl":"10.31547/bct-2025-027","url":null,"abstract":"<p><p>Delayed neurological toxicity, distinct from acute immune effector cell-associated neurotoxicity (ICANS), is an emerging complication of ciltacabtagene autoleucel (cilta-cel), a B-cell maturation antigen (BCMA)-targeting CAR T-cell therapy. Peripheral nerve (PN) involvement has been described as cranial nerve palsies or Guillain-Barré-like syndromes, yet the underlying mechanisms remain poorly defined. We describe a case of asymmetric, immune-mediated multifocal PN involvement, clinically resembling autoimmune, T-cell-mediated mononeuritis multiplex (MNM), occurring after cilta-cel therapy. Several months post-infusion, the patient developed progressive asymmetric sensorimotor neuropathy preceded by bilateral facial nerve palsies. Electrodiagnostic studies confirmed multifocal axonal involvement, and nerve biopsy revealed Wallerian degeneration with CD3+ and CAR+ T-cell infiltration in the absence of BCMA expression on neural tissue. These findings suggest that delayed neurotoxicity may arise from immune-mediated, BCMA-independent mechanisms involving off-target tissue inflammation. Although CAR T-cells were detected within the affected nerve tissue, their pathogenic significance remains unclear and may reflect antigen-independent infiltration, immune activation or secondary bystander recruitment in the setting of immune dysregulation. The patient demonstrated marked neurological recovery following corticosteroids and cyclophosphamide, an immunosuppressive regimen modeled on MNM treatment. This case underscores the importance of comprehensive neurodiagnostic evaluation and early immunosuppression in managing delayed, non-ICANS CAR T-cell neurotoxicity.</p>","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 2","pages":"55-59"},"PeriodicalIF":0.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual Infections following Haploidentical Hematopoietic Stem cell Transplant in a Case with severe Aplastic Anaemia'.","authors":"Manaswinee Mallik, Sarthak Wadhera, Sucheta Guleria, Harsimran Kaur, Valliappan Muthu, Sumeeta Khurana, Charanpreet Singh, Arihant Jain, Gaurav Prakash, Pankaj Malhotra, Alka Khadwal","doi":"10.31547/bct-2025-022","DOIUrl":"10.31547/bct-2025-022","url":null,"abstract":"<p><p>We report a case of very severe aplastic anemia who developed from an uncommon bacterial, recalcitrant parasitic infection and viral reactivation after haploidentical hematopoietic stem cell transplant. The risk factors for multiple infections in this setting included immunocompromised state due to pretransplant prolonged immunosuppression, viral reactivation and graft-versus-host disease (GVHD) requiring multiple immunosuppressive agents. The index case was successfully treated for pulmonary nocardiosis, refractory giardiasis, cytomegalovirus, and adenovirus reactivation highlighting significant challenges during the management of underlying GVHD and these infections.</p>","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 2","pages":"50-54"},"PeriodicalIF":0.0,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menstrual patterns and gonado-sexual health following hematopoietic transplant in reproductive age women and the role of hormone replacement therapy.","authors":"Riya Jain, Aashima Arora, Arihant Jain, Deepesh Lad, Aseem Mehra, Charanpreet Singh, Aditya Jandial, Gaurav Prakash, Alka Khadwal, Reena Das, Vanita Jain, Pankaj Malhotra","doi":"10.31547/bct-2025-019","DOIUrl":"10.31547/bct-2025-019","url":null,"abstract":"<p><strong>Background: </strong>Menstrual patterns, reproductive sequelae, sexual health, and the role of hormone replacement therapy (HRT) among women following hematopoietic stem cell transplantation (HSCT) remain underexplored. This study evaluated menstrual resumption, ovarian reserve, fertility outcomes, sexual function, and attitudes towards HRT among women who underwent HSCT.</p><p><strong>Methods: </strong>This single-centre retrospective, cross-sectional analysis included women aged 18-45 years who had undergone HSCT for haematological malignancies and were on follow-up of at least 6 months post-HSCT. Data collected encompassed demographic details, disease characteristics, prior treatments, and transplant details. Menstrual patterns, anti-Müllerian hormone (AMH) levels, antral follicular counts (AFC), and the female sexual function index (FSFI) were measured among HSCT recipients at the time of study recruitment and compared with 30 age-matched healthy controls. Women with premature ovarian insufficiency (amenorrhea and follicle stimulating hormone [FSH] > 40 IU/L) were offered HRT. Among women who were administered HRT, 6 months follow-up menstrual resumption rates and FSFI assessments were done.</p><p><strong>Results: </strong>Among the 30 women enrolled, 86.6% (26/30) of patients had normal menstruation pre-HSCT, which declined to 23% (7/30) post-HSCT (<i>p</i> < 0.001). The median AMH level in the cases was 0.01 ng/mL (Range: 0.01-0.76), which was significantly lower than that of the controls (median: 2 ng/mL, range: 0.11-8.11). The AFC (median: 0, range: 0-5) was also significantly lower in HSCT recipients compared to controls (median: 11, range: 3-19) (<i>p</i> < 0.001). None of the HSCT recipients exhibited normal ovarian reserve post-HSCT. The proportion of patients with AMH levels above 0.01 ng/mL was higher in the subgroup that had return of spontaneous menses (n=5/7, 71.4%) compared to the subgroup that did not have return of menses (n=4/23, 17.4%); <i>p</i>=0.01. Similarly, the proportion of patients with an AFC greater than 1 was higher in the subgroup that resumed menstruation (6/7, 85.7%) compared to those who did not resume menstruation (3/23, 13%); <i>p</i> < 0.001. Among women desiring pregnancy, two achieved spontaneous conception resulting in healthy live births. A majority (24/26, 92.7%) of sexually active women exhibited sexual dysfunction (FSFI < 26.5) post-HSCT. HRT was offered to 23 women with premature ovarian insufficiency; however, 52.2% refused therapy. Among those who received HRT for at least six months, a significant improvement in the FSFI score was observed (<i>p</i> < 0.03).</p><p><strong>Conclusions: </strong>Ovarian and sexual dysfunction are frequent in post-HSCT women; a subset resumes spontaneous menstruation. Spontaneous conceptions may be observed despite low ovarian reserve markers. HRT may have a potential role to improve sexual and menstrual functions.</p>","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 2","pages":"41-49"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fecal Calprotectin as a biomarker for early diagnosis and prediction of steroid response in Acute Gastrointestinal Graft versus Host Disease.","authors":"Santhosh E Kumar, Sushil Selvarajan, Tintu Varghese, P Krishna Bharadwaj, Kovi Sai Lakshmi, Shreyas Hanmantgad, Amit Kumar Dutta, A J Joseph, Vikram Mathews, Biju George","doi":"10.31547/bct-2025-016","DOIUrl":"10.31547/bct-2025-016","url":null,"abstract":"<p><strong>Background: </strong>Acute gastrointestinal graft-versus-host disease (GI-GVHD) is a complication of allogeneic hematopoietic stem cell transplantation (HSCT) that requires early diagnosis. Fecal calprotectin (FC) is a biomarker of intestinal inflammation. We studied the role of FC in differentiating GI-GVHD from other diarrhea.</p><p><strong>Methods: </strong>We prospectively studied allogeneic HSCT recipients between 2017 and 2020. FC levels were measured pre-transplant, on post-transplant day 14, on day 1 of diarrhea, and post-steroid treatment (day 3-7 of steroid treatment).</p><p><strong>Results: </strong>We studied 116 patients with median age 14.5 (5-29) years; 84 were male (72.4%). Fifty-seven patients (49.1%) developed diarrhea post-HSCT, 34 (59.7%) patients had GI-GVHD, and 23 patients (40.3%) developed other diarrheal illnesses. FC level on day1 of diarrhea among GI-GVHD patients (n=33) was higher (63 μg/g [Q1-Q3:25.6-358.5]) compared to other diarrhea (27.5 μg/g [21.1-60.4], <i>p=0.045</i>). FC cut-off > 53.7 μg/g had sensitivity (78.6%) and specificity (57.9%) with area under the receiver operating characteristic curve of 0.67 to predict GI-GVHD on day 1 of diarrhea. FC levels in steroid non-responders (n=7) were higher (311.5 μg/g [40.5-1,291.5]) than responders (n=11) (31.2 μg/g [20.8-137.2] μg/g); <i>p=0.03</i>. Haplomatch, severe GI-GVHD, and coexisting skin GVHD were significant predictors of poor treatment response.</p><p><strong>Conclusion: </strong>A higher FC value on day 1 of diarrhea aids in the diagnosis of acute GI-GVHD and predicts poor response to treatment.</p>","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 1","pages":"31-40"},"PeriodicalIF":0.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Outcomes of Allogeneic Stem Cell Transplantation in Relapsed Hodgkin Lymphoma: A Single-Center Experience from India.","authors":"Sarthak Wadhera, Rudra Narayan Swain, Aarushi Sahni, Charanpreet Singh, Aditya Jandial, Arihant Jain, Man Updesh Sachdeva, Rekha Hans, Deepesh Lad, Gaurav Prakash, Pankaj Malhotra, Alka Khadwal","doi":"10.31547/bct-2025-018","DOIUrl":"10.31547/bct-2025-018","url":null,"abstract":"<p><strong>Background: </strong>Relapsed Hodgkin lymphoma (HL) after autologous stem cell transplantation (auto-HSCT) remains a major therapeutic challenge with few curative options. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) may provide durable disease control, yet outcome data from tertiary-care centres in India are limited.</p><p><strong>Objective: </strong>To evaluate real-world outcomes of allo-HSCT in patients with chemotherapy-sensitive relapsed HL at a tertiary care centre in North India.</p><p><strong>Methods: </strong>This retrospective study included patients with chemotherapy-sensitive relapsed HL who underwent allo-HSCT at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, between January 2017 and December 2023. Clinical data including baseline characteristics, transplant parameters, complications, and survival outcomes were reviewed. Descriptive statistics were used, and overall survival (OS) was estimated using the Kaplan-Meier method.</p><p><strong>Results: </strong>Five patients (median age 18 years; range 14-30) with chemotherapy-sensitive relapse following auto-HSCT underwent allogeneic transplantation in complete remission (CR) after salvage therapy. Donors included haploidentical (n=3), matched unrelated (n=1), and matched sibling (n=1). Four patients received reduced-intensity conditioning; one received myeloablative conditioning. Graft-versus-host disease (GVHD) prophylaxis included post-transplant cyclophosphamide (PT-Cy) in four patients. Neutrophil and platelet engraftment occurred at median 15 and 16 days, respectively. All patients developed bacterial infections; one succumbed to Gram-negative sepsis. Acute grade III GVHD occurred in one patient, and two developed limited chronic GVHD. At a median follow-up of 44 months, four patients remained in continuous remission, with a 3-year OS of 80%.</p><p><strong>Conclusion: </strong>In Indian patients with chemotherapy-sensitive relapsed HL, allo-HSCT using reduced-intensity and reduced toxicity conditioning regimens and post-transplant cyclophosphamide-based regimens has proven feasible and effective, yielding encouraging survival outcomes within routine clinical practice.</p>","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 1","pages":"25-30"},"PeriodicalIF":0.0,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Outcomes After Haploidentical Hematopoietic Cell Transplantation in Elderly Patients with Myeloid Malignancies in India: A Single Center Experience.","authors":"Sayan Sinha Roy, Chandrachud Potdar, Bharath Vikrem, Manoj Kumar Singh, Manish Singh, Dinesh Chandra, Khaliqur Rahman, Ruchi Gupta, Rajesh Kashyap","doi":"10.31547/bct-2025-025","DOIUrl":"10.31547/bct-2025-025","url":null,"abstract":"","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 1","pages":"21-24"},"PeriodicalIF":0.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Allogeneic Stem Cell Transplantation in Myelofibrosis - A Single Center Experience.","authors":"Nutan Joshi, Uday Kulkarni, Sushil Selvarajan, Sharon Lionel, Anu Korula, Fouzia Na, Kavitha M Lakshmi, Madhavi Maddali, Eunice Sindhuvi, Poonkuzhali Balasubramanian, Aby Abraham, Vikram Mathews, Biju George","doi":"10.31547/bct-2025-014","DOIUrl":"10.31547/bct-2025-014","url":null,"abstract":"<p><strong>Background: </strong>There is paucity of data on the outcomes of allogeneic stem cell transplantation (allo-SCT) for myelofibrosis, from developing countries.</p><p><strong>Materials and methods: </strong>This is a retrospective analysis of patients undergoing allogeneic stem cell transplant for myelofibrosis at our center between January 1998 to December 2023.</p><p><strong>Results: </strong>Thirty-four patients underwent allogeneic transplantation with a median age of 46 (19-68) years with 24 (70.6%) being males. The median dynamic international prognostic scoring system (DIPSS) Score was 3 (2-4). JAK2 was the most common driver mutation, in 10 (34.5%) patients. Majority of patients received reduced intensity conditioning with Fludarabine-Melphalan +/-total body irradiation (n=32) and all had peripheral blood grafts with donor source being matched sibling in 22 (64.7%), unrelated donor in 9 (26.5%) [7 full HLA match, one 9/10 HLA match and one 8/10 HLA match] and haploidentical in 3 (8.8%). The median CD34 cell dose infused was 9.9 (3.4-22) × 10⁶/kg. The majority received calcineurin inhibitor + methotrexate (n=28) as Graft versus Host Disease (GVHD) prophylaxis. Two patients died before day 14 due to sepsis while 3 (9.3%) had primary graft failure. Neutrophil engraftment occurred in 29 patients (85.3%) at a median of 15 (range 8-25) days. Acute GVHD was noted in 20 (58.8%) patients with grade 3-4 GVHD in 13 (38.2%). Chronic GVHD was noted in 12 patients with 4 being extensive chronic GVHD as per revised Seattle criteria. On last follow up, 15 (44.1%) patients are alive while 19 have died.</p><p><strong>Conclusion: </strong>Allo-SCT for myelofibrosis is associated with reasonable cure rates, however strategies to reduce graft failure and GVHD are required.</p>","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuromyelitis Optica Spectrum Disorder in a Pediatric Patient Following Haploidentical Hematopoietic Stem Cell Transplantation for Acute Myeloid Leukemia.","authors":"Georgii Zurabovich Seregin, Natalia Vitalievna Bronina, Eugenii Andreevich Burtsev, Bulat Maksutovich Kurmanov, Anna Vsevolodovna Lifshits, Gleb Olegovich Bronin","doi":"10.31547/bct-2025-021","DOIUrl":"10.31547/bct-2025-021","url":null,"abstract":"<p><p>This report describes a rare pediatric case of seronegative neuromyelitis optica spectrum disorder (NMOSD) following a second haploidentical hematopoietic stem cell transplantation (HSCT) for relapsed acute myeloid leukemia (AML). The neurological syndrome, featuring simultaneous optic neuritis and myelitis, emerged alongside classic chronic graft-versus-host disease (GVHD) manifestations (lichenoid oral changes, arthritis) on day +145 post-transplant. The diagnosis of seronegative NMOSD was established based on clinical and MRI findings, after exclusion of infectious etiologies and absence of aquaporin-4 IgG antibodies in blood and cerebrospinal fluid. Corticosteroids were avoided due to the risk of AML relapse. Instead, plasma exchange, immunotherapy with rituximab and cyclophosphamide, followed by intravenous immunoglobulin maintenance induced rapid neurological improvement and parallel resolution of GVHD symptoms. This case underscores the central nervous system as a target for alloimmunity and presents a successful steroid-sparing treatment strategy for NMOSD manifested after allogenic HSCT.</p>","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 1","pages":"17-20"},"PeriodicalIF":0.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Survey for Antiemetics in Hematopoietic Stem Cell Transplantation in the APBMT Centers.","authors":"Kimikazu Yakushijin, Jacinta Perram, Aloysius Ho, Tasneem Farzana, Hiroatsu Iida, Jong Wook Lee, Yoshihiro Inamoto, Biju George, Depei Wu, Ritsuro Suzuki, Maryam Behfar, He Huang, Thiti Asawapanumas, Philip Rowlings, Bishesh S Poudyal, Damai Santosa, Aye Aye Gyi, Otgonbat Altangerel, Chinadol Wanitpongpun, Gin Gin Gan, Satoshi Iyama, Shahid Iqbal, Mani Ramzi, Alka Khadwal, Jun Kato, Joycelyn Sim, Jessica Cheng, David Ma, Yi Xuan Chua, Shinichiro Okamoto, Minako Iida, Shigeo Fuji","doi":"10.31547/bct-2025-020","DOIUrl":"10.31547/bct-2025-020","url":null,"abstract":"<p><p>Antiemetic therapy is an essential component of supportive care following hematopoietic stem cell transplantation (HSCT). Chemotherapy and irradiation used in conditioning regimens frequently induce severe nausea and vomiting, which can significantly impair patients' quality of life. Although recent guidelines recommend a triple combination of a 5-hydroxytryptamine-3 (5-HT₃) receptor antagonist, dexamethasone, and an neurokinin 1 (NK1) receptor antagonist, antiemetic practices vary widely across countries and regions. This study aimed to investigate current antiemetic policies among the Asia-Pacific Blood and Marrow Transplantation (APBMT) centers. A web-based questionnaire survey using SurveyMonkey was distributed via email from the APBMT office between December 7, 2021, and January 21, 2022. The survey addressed antiemetic strategies used in HSCT conditioning regimens. Responses were received from 28 centers across 14 countries. Among the participating centers, 93% reported that physicians were primarily responsible for antiemetic decision-making, with limited involvement from pharmacists or multidisciplinary teams. The most commonly used conditioning regimens for allogeneic HSCT were busulfan and cyclophosphamide (Bu-CY) (72%) and fludarabine and busulfan (Flu-Bu) (62%), whereas high-dose melphalan (83%) and carmustine (BCNU), etoposide, cytarabine arabinoside, and melphalan (BEAM) (69%) were predominant for autologous HSCT. Despite guidelines recommending olanzapine as an additional antiemetic in highly emetogenic chemotherapy, its routine implementation remains limited, even in high-risk settings. Notably, dexamethasone is frequently avoided in allogeneic HSCT, likely due to concerns about its immunosuppressive effects. The incidence of vomiting varied, with 36% of centers reporting rates of 10% or higher, even among those with institutional antiemetic policies. In conclusion, this survey highlighted substantial variation in antiemetic strategies across the APBMT centers. The limited use of olanzapine reflects ongoing concerns regarding its side effects, while the frequent avoidance of dexamethasone in allogeneic HSCT represents a deviation from current guideline recommendations. Given the complexity of HSCT and the varying side effect profiles of antiemetic agents, a multidisciplinary approach to treatment planning, including that of pharmacists and dietitians, could optimize supportive care. Future prospective studies are warranted to evaluate the safety, efficacy, and feasibility of olanzapine- and steroid-sparing antiemetic strategies to improve patient outcomes.</p>","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 1","pages":"9-16"},"PeriodicalIF":0.0,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}